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近年临床试验及指南对中西医结合治疗冠心病的启示

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中西医结合心脑血管病杂志 2009年第4期7卷 379-381页

作者：陈浩史大卓中国中医科学院中国中医科学院西苑医院

近年发表的临床试验研究结果的公布在心血管领域,尤其是在介入治疗方面产生很大影响。中西医结合在防治冠心病方面如何按照循证医学原则,发挥中西医互补优势,以主要临床终点事件为观察目标,客观评价其疗效,是目前中西医结合防治冠心病... 详细信息

近年发表的临床试验研究结果的公布在心血管领域,尤其是在介入治疗方面产生很大影响。中西医结合在防治冠心病方面如何按照循证医学原则,发挥中西医互补优势,以主要临床终点事件为观察目标,客观评价其疗效,是目前中西医结合防治冠心病面临的一个主要问题。

关键词：循证医学临床试验中西医结合冠心病

XS0601 reduces the incidence of restenosis:a prospective study of 335 patients undergoing percutaneous coronary intervention in China

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XS0601 reduces the incidence of restenosis:a prospective stu...

Effects of Chinese patent medicines on restenosis after percutaneous coronary intervention

作者：陈可冀 shi da-zhuo XU Hao Lü Shu-zheng LI Tian-chang KE Yuan-nan ZHANG Min-zhou LU Xiao-yan SUN Rui-yuan YOU shi-jie 中国中医科学院西苑医院心血管病中心 Xiyuan Hospital China Academy of Chinese Medical Sciences Department of Cardiology Anzhen HospitalCapital University of Medical Sciences Department of Cardiology Tongren HospitalCapital University of Medical Sciences Department of Cardiology China-Japan Friendship Hospital Guangdong Provincial Hospital of Traditional Chinese Medicine

Background XS0601,consisting of active ingredients(Chuangxiongol and paeoniflorin),has been shown to inhibit arterial neointimal hyperplasia in animal models and in preliminary human *** objective of this study was to evaluate the safety and efficacy of XS0601 in preventing restenosis following percutaneous coronary intervention(PCI).Methods A multi-center,randomized,double-blind,placebo-controlled trial was conducted.A total of335 patients were randomized into treatment with the oral administration of XS0601,or a placebo for 6months after successful *** follow-up was scheduled at 6 months,and clinical follow-ups performed at 1,3 and 6 months after *** primary end point was angiographic *** secondary end points were the combined incidence of death,target lesion nonfatal myocardial infarction,repeat angioplasty,and coronary artery bypass graft *** A total of 308 patients(91.9%) completed the study and 145 cases(47.1%) received angiographic *** restenosis rates were significantly reduced in the XS0601 group as compared with the placebo group(26.0%vs.47.2%,P < 0.05),and the minimum lumen diameter(MLD) was greater[(2.08 + 0.89) mm for XS0601 vs.(1.73 ± 0.94) mm for placebo,P < 0.05].XS0601 also significantly reduced the combined incidence of major adverse cardiac event(10.4%in the XS0601 group vs.22.7%) in the placebo group,P < 0.05).The incidence of recurrent angina at 3 and 6 months after PCI was also significantly reduced in XS0601 group(7.1%and 11.0%) as compared with those in placebo group(19.5%and 42.9%)(P < 0.05).No significant side effects occurred within the 6-month follow-up period in the XS0601 *** Administration of XS0601 for 6 months is demonstrated to be safe and effective in reducing restenosis in post-PCI patients.

关键词： XS0601 angioplasty stent restenosis

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Effects of Chinese patent medicines on restenosis after perc...

蒺藜总皂苷对缺氧复氧心肌细胞TNF-α,IL-1β及ICAM-1表达的影响

第三届中日双边药理学和临床药理学学术会议

作者： CHEN Ke-Ji shi da-zhuo XU Hao MA Xiao-Juan (Cardiovascular Lab Xiyuan Hospital China Academy of Chinese Medical Sciences Beijing 100091 China)

＜正＞AIM Percutaneous coronary intervention （PCI） is an effective approach to coronary heart disease （CHD）,which significantly reduce the mortality and the complication incidences in admission,however restenosis, no-reflow and recurrent cardiovascular events,etc.,after successful PCT have became a great challenge for CHD *** changes associated with restenosis, such as vascular intimal thickening,platelet activation, endothelial dysfunction,and so on,are related to blood stasis according to basic theory of traditional Chinese med- icine （TCM）.So we have investigated the effect of Chinese patent medicines （CPM） with the action of blood- activating and stasis-resolving on restenosis after PCI from *** experiments proved CPM inhibited neointi- mal hyperplasia and prevented vascular remodeling,and which improved symptoms and the long-term prognosis of CHD patients with successful PCT in a small sample clini- cal *** order to objectively evaluate clinical signifi- cance of CPM to post-PCI patients,we conducted a multi- center,randomized,double-blind,placebo-controlled tri- *** A total of 335 patients were randomized into treatment with the oral administration of Xiongshao capsule （consist of effective components extracted from both Chuanxiongol and paeoniflorin which are common used in TCM clinical practice to promote blood circula- tion）,or a placebo for 6 months after successful ***- giographic follow-up was scheduled at 6 months,and clini- cal follow-up performed at 1,3 and 6 months after PCI. The primary end points were angiographic restenosis,and the combined incidence of *** secondary end points were target lesion,nonfatal myocardial infarction, repeat angioplasty,and coronary artery bypass graft surgery. RESULTS A total of 308 patients （91.9%） completed the study and 145 cases （47.1%） received angiographic *** restenosis rates were significantly reduced in the Xiongshao capsule group as compared with the pla-

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中国新药杂志 2006年第22期15卷 1934-1936页

作者：殷惠军王显刚史大卓中国中医科学院西苑医院心内科北京100091 山东中医药大学济南250014

目的:观察蒺藜总皂苷(gross saponins from Tribulus terrestris L,GSTT)对缺氧复氧心肌细胞炎症分子肿瘤坏死因子-α(TNF-α),白介素1β(IL-1β)及细胞间黏附分子-1(ICAM-1)表达的影响。方法:利用原代培养的SD乳鼠心肌细胞建立心肌缺... 详细信息

目的:观察蒺藜总皂苷(gross saponins from Tribulus terrestris L,GSTT)对缺氧复氧心肌细胞炎症分子肿瘤坏死因子-α(TNF-α),白介素1β(IL-1β)及细胞间黏附分子-1(ICAM-1)表达的影响。方法:利用原代培养的SD乳鼠心肌细胞建立心肌缺氧复氧模型,分为正常组、模型组和GSTT高、低浓度(50,10mg·L^(-1))组。用放免法检测TNF-α和IL-1β,细胞ELISA检测ICAM-1表达。结果:与模型组比较,GSTT高、低浓度(50,10mg·L^(-1))组TNF-α和IL-1β含量显著降低(P＜0．01或P＜0．05);GSTT 50 mg·L^(-1)组ICAM-1蛋白表达量显著降低(P＜0．05)。结论:GSTT对缺氧复氧损伤心肌细胞有保护作用,其机制与抑制炎性因子TNF-α和IL-1β释放,降低ICAM-1蛋白表达有关。

关键词：心肌细胞蒺藜总皂苷缺氧复氧肿瘤坏死因子-α 白介素1β 细胞间黏附分子-1(ICAM-1)

气血并治方有效组分对载脂蛋白E基因敲除小鼠动脉粥样硬化不稳定斑块的干预作用

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中国药理学与毒理学杂志 2008年第4期22卷 263-269页

作者：刘剑刚董国菊史大卓王永炎中国中医科学院西苑医院心血管科北京100091 中国中医科学院北京100700

目的探讨气血并治方水提取物有效组分(CWQB)配伍对载脂蛋E基因敲除(ApoE-)小鼠晚期动脉粥样硬化不稳定斑块的干预作用及其可能的作用机制。方法6周龄ApoE-小鼠,给予高脂饲料,随机分为模型组、辛伐他汀2.5mg·kg-1组、CWQB 72和360mg·k... 详细信息

目的探讨气血并治方水提取物有效组分(CWQB)配伍对载脂蛋E基因敲除(ApoE-)小鼠晚期动脉粥样硬化不稳定斑块的干预作用及其可能的作用机制。方法6周龄ApoE-小鼠,给予高脂饲料,随机分为模型组、辛伐他汀2.5mg·kg-1组、CWQB 72和360mg·kg-1组。从24周龄起灌胃给药,每日1次,连续12周。同时取同龄C57BL/6小鼠作为正常对照。36周龄时麻醉处死,检测血脂水平和主动脉病理变化,免疫组织化学及计算机图像处理系统分析主动脉斑块中巨噬细胞内CD68的表达和平滑肌细胞内α-肌动蛋白的表达。结果CWQB及辛伐他汀均能降低小鼠的血脂水平,降低其胆固醇含量,升高高密度脂蛋白水平。CWQB大剂量组和辛伐他汀组可见主动脉斑块纤维帽厚度增加,斑块面积和管腔面积的比值下降;斑块中平滑肌细胞内α-肌动蛋白表达增加,巨噬细胞内CD68表达减少。结论CWQB具有一定的消减和稳定主动脉斑块的作用,其机制可能与其降低血脂水平、减少斑块内巨噬细胞浸润和增加血管平滑肌细胞数量有关。

关键词：气血并治方载脂蛋白E类小鼠,基因敲除动脉硬化巨噬细胞肌,平滑,血管

莪术主要化学成分预防支架后再狭窄药理作用的研究进展

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中国中药杂志 2015年第7期40卷 1230-1234页

作者：崔源源刘剑刚赵福海史大卓中国中医科学院心血管病研究所北京100091

中药莪术主要含挥发油、姜黄素等有效成分,具有抗血小板聚集、降血脂、抗氧化及抗炎等药理作用。近年来,研究表明莪术某些提取物和化学成分通过增强血管血红素氧合酶-1活性,缓解心肌细胞线粒体损伤以保护血管内皮;抑制核因子-κB(NF-κB... 详细信息

中药莪术主要含挥发油、姜黄素等有效成分,具有抗血小板聚集、降血脂、抗氧化及抗炎等药理作用。近年来,研究表明莪术某些提取物和化学成分通过增强血管血红素氧合酶-1活性,缓解心肌细胞线粒体损伤以保护血管内皮;抑制核因子-κB(NF-κB)、靶基因白介素-受体相关激酶-1(IRAK-1)、肿瘤坏死因子受体相关因子-6(TRAF-6)和血管细胞黏附分子-1(VCAM-1)减少炎症浸润;且通过影向细胞磷酸酶氧化以抑制生长因子诱导的平滑肌细胞增殖及迁移等多重药理作用。因此,利用莪术对血管内皮细胞和平滑肌细胞的不同药理作用,应用于药物涂层支架,对预防支架后再狭窄和血栓形成可能具有潜在作用。该文就中药莪术提取物及主要化学成分,对预防支加内再狭窄的药理作用及机制研究作一综述。

关键词：支架后再狭窄莪术提取物药理作用化学成分肿瘤坏死因子受体相关因子预防平滑肌细胞增殖血管内皮细胞

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介入术后冠心病中医证候诊断标准的评价

中国中西医结合杂志 2013年第8期33卷 1036-1041页

作者：郗瑞席陈可冀史大卓李立志中国中医科学院西苑医院心血管病中心北京100091

目的评价通过专家咨询建立的介入术后冠心病主要中医证候诊断标准的真实性、可靠性和临床应用价值。方法对23家医院1050例介入术后冠心病患者,采用诊断试验的评价方法,通过灵敏度、特异度、准确度、阳性似然比及ROC曲线下面积,评价介入... 详细信息

目的评价通过专家咨询建立的介入术后冠心病主要中医证候诊断标准的真实性、可靠性和临床应用价值。方法对23家医院1050例介入术后冠心病患者,采用诊断试验的评价方法,通过灵敏度、特异度、准确度、阳性似然比及ROC曲线下面积,评价介入术后冠心病主要中医证候诊断标准的真实性;通过观察符合率和Kappa值,评价该标准的可靠性;通过阳性预测值和阴性预测值,评价该标准的临床应用价值。结果前期建立的介入术后冠心病主要中医证候诊断标准,其灵敏度、特异度、准确度、阳性似然比、ROC曲线下面积、观察符合率、Kappa值、阳性预测值、阴性预测值如下:血瘀证分别为95.26%、93.70%、94.86%、15.13、0.924、98.76%、0.969、97.76%、87.24%;气虚证分别为96.42%、95.34%、96.00%、20.70、0.957、99.52%、0.990、97.02%、94.42%;痰浊证分别为88.19%、96.46%、94.19%、24.89、0.923、96.67%、0.915、90.39%、95.58%;心血瘀阻证分别为91.06%、98.77%、97.05%、74.22、0.950、98.67%、0.960、95.54%、97.46%;气虚血瘀证分别为98.41%、96.73%、97.33%、30.10、0.976、98.86%、0.976、94.40%、99.09%;痰瘀互阻证分别为94.81%、94.75%、94.76%、18.07、0.948、97.71%、0.918、72.73%、99.20%。结论介入术后冠心病主要中医证候诊断标准,具有较高的真实性、可靠性和临床应用价值。

关键词：冠心病介入术中医证候诊断标准评价

Characteristics and origin of low-organicmatter carbonate source rocks in the Middle-Upper Ordovician, Tarim Basin, northwestern China

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Journal of Palaeogeography 2024年第3期13卷 594-619页

作者： Jun-Qing Chen Fu-Jie Jiang Xiong-Qi Pang Hai-Jun Yang Kan-Yuan shi Bo Pang Hong Pang Jian-Fa Chen zhuo-Heng Chen Xin-Gang Zhang Song Wu State Key Laboratory of Petroleum Resources and Engineering China University of Petroleum(Beijing)Beijing 102249China Basic Research Center for Energy Interdisciplinary College of ScienceChina University of Petroleum(Beijing)Beijing 102249China Beijing Key Laboratory of Optical Detection Technology for Oil and Gas China University of Petroleum(Beijing)Beijing 102249China College of Geosciences China University of Petroleum(Beijing)Beijing 102249China Research Institute of Petroleum Exploration and Development PetroChina Tarim Oilfield CompanyKorla 841000Xinjiang Uygur Autonomous RegionChina Geological Survey of Canada Natural Resources CanadaCalgary T2L 2A7Canada

The continually-discovered large volumes of marine hydrocarbons indicate a huge exploration potential within the carbonate rocks of Ordovician in the Tarim Basin,northwestern *** Middle-Upper Ordovician(O2+3)carbonate source rocks are at a highly mature *** rocks presently contain a low amount of total organic carbon(TOC_(pd)≤0.5%)(TOC_(pd) means the present-day TOC).A mass balance approach is used to identify the source rocks that have expelled *** characteristics and origin of hydrocarbon expulsion from low-TOC_(pd) source rocks are studied,which are significant for oil exploration in the *** results showed that a low-TOC_(pd) O2+3 source rock having expelled hydrocarbons was type I and had a very narrow oil *** a high rock maturity and a high original TOC(TOCo)value exceeding 1%,nearly 80%of the generated hydrocarbons were *** content of gammacerane and C28 steranes in the oil and source rock extracts were relatively lean,with a V-shaped distribution of regular steranes,suggesting a possible genetic relation between the low-TOC_(pd) source rocks and the marine oil in the Tabei *** planktonic algae or acritarchs were the main hydrocarbon parent materials,distributed in the subsiding platform-slope *** matter was preserved under reducing conditions,and source rocks were formed with a favorable kerogen type and a moderate hydrocarbon generation *** study illustrates the hydrocarbon expulsion of low TOC_(pd) source rocks in northern Tarim Basin,which is greatly significant for analyzing the genesis of marine crude oil in Tarim Basin,and evaluating the distribution of marine source *** research method is theoretically significant for oil and gas exploration in the same type of highlymature carbonate paleobasins.

关键词： Carbonate source rock Mass balance approach Present-day TOC Genesis mechanism Tarim Basin

参芪扶心口服液对心肌梗死后左心衰大鼠血浆利钾尿肽与心脏重塑的影响

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中国药学杂志 2005年第21期40卷 1629-1632页

作者：马路刘剑刚陈可冀史大卓薛桥李泱高伟中国中医研究院西苑医院北京100091 解放军总医院老年心血管病研究所北京100853

目的观察参芪扶心口服液对实验性心肌梗死(心梗)后心力衰竭(心衰)大鼠血浆利钾尿肽(KP)、左室舒缩功能及左室重塑的影响。方法结扎大鼠左冠状动脉前降支制作急性心肌梗死后心衰模型,左心室插管术测定血液动力学指标;放免法测定血浆KP,... 详细信息

目的观察参芪扶心口服液对实验性心肌梗死(心梗)后心力衰竭(心衰)大鼠血浆利钾尿肽(KP)、左室舒缩功能及左室重塑的影响。方法结扎大鼠左冠状动脉前降支制作急性心肌梗死后心衰模型,左心室插管术测定血液动力学指标;放免法测定血浆KP,心钠素(ANP),血管紧张素Ⅱ(AngⅡ)及内皮素-1(ET-1)浓度,并观察心脏形态学结构及胶原成分、心脏质量/体质量(HM/BM)、左心腔面积(LVA)、单位面积内心肌细胞核数(MNN)的变化。结果与模型组相比,高剂量(15g·kg^(-1))组等容收缩未期心肌缩短最大速度(V_(max))、左心室舒张期压力下降最大变化速率(-dp/dt_(max))及左心室内压峰值(LVSP)增加;左心室舒张末压(LVEDP)降低;血浆KP,AngⅡ及ET-1浓度降低,均有显著性差异(P<0.05或P<0.01)。心肌细胞周围胶原组织明显减少,心脏质量/体质量心脏比值变小、单位面积内MNN明显增多、LVA明显缩小(P<0.05或P<0.01)。中剂量组(10g·kg^(-1))、低剂量组(5g·kg^(-1))血浆ANP水平下降明显(P<0.01)。结论参芪扶心口服液能改善心梗后心衰大鼠左室舒缩功能,降低KP,AngⅡ,ET-1浓度,影响ANP分泌,有一定抑制左室重塑的作用。

关键词：参芪扶心口服液心肌梗死心力衰竭心室重塑利钾尿肽